Imara Healthcare Centre Projecupdated June 17th 2019

The Community Served by theProject

Mukuru, where the Imara Healthcare Centre is located, is a large slum in Nairobi, Kenya and is home to over 80,000 people. It is near the industrial belt in Nairobi and many of the inhabitants have left rural homes because of poverty and have come to the city in the hope of finding work. The majority of the people are unskilled and uneducated and remain jobless. The housing is made from cardboard, plastic and corrugated iron sheets. These one-roomed houses are small and have no sanitation or running water. There is no waste collection and most of the household waste goes directly into the nearby river. Fire is a constant threat. There is no infrastructure and electricity is generally not available. The lack of sanitation and clean drinking water, combined with poverty and poor housing conditions, leads to a host of healthcare issues. Every year in this slum, thousands of people die due to malaria, HIV/AIDS and water-borne diseases.

The Healthcare Centre

Alan and Mona Fox with Peter Inoti in 2011

In 2002,
Peter and Francisca Inoti established a medical clinic in the Mukuru slum to provide basic health services to that
community.These included first aid, antenatal
and postnatal care, HIV/AIDS awareness and testing, immunizations and community
health education and prevention.
The Centre does not receive any direct government support for
the services it offers. It relies on income from clients but that is limited as
the Centre has a policy to provide service of those in need regardless of
ability to pay. Donations from supporters and occasional short term
project funding also helps but there is a constant struggle to keep staff when
their pay is low and they can earn more elsewhere.
Donors include a network of friends, who in some cases are past
volunteers at Imara. Membership in the Christian Health Association
of Kenya (CHAK) enables the Centre to buy drugs and medical supplies at a
discounted price.

Post natal care clients

Eganville Rotary AssistanceInJanuary 2012, The Rotary Club of Eganville Charitable Trust signed a working agreement with Peter and Francisca Inoti and the Imara Healthcare Centre, to provide on-going financial support to the Centre. Over the following months assistance has been provided to upgrade the electrical wiring and install donated LED bulbs, buy used furniture for a consultancy room, purchase 10 beds and mattresses for the maternity ward and day clinic. Eganville Rotary has also assisted with the purchase of badly needed medical supplies and medicines. Medical supplies have been donated to the Imara Centre by the Renfrew Victoria Hospital as well as the county of Renfrew Ambulance Service. These supplies have been taken to Nairobi by students from Renfrew Collegiate Institute and Opeongo High School, who were traveling to Kenya to participate in a school building program.

Problem with DrainageEganville Rotarians Alan & Mona Fox
visited Kenya in October 2012 and discussed with Peter and Francisca, their
priorities for the future development of the Imara Healthcare
Centre. They identified drainage as the most urgent problem to
address. Whenever there are heavy rains, the central passage
way in the clinic floods. This is not only a health risk butalso a major expense having to pump the
septic tank so frequently. An engineer‘s report recommended raising the rear part of the building
by about a meter so that water and waste can be fed into the municipal
sewer. It was also proposed to install a concrete slab for a roof
to enable future expansion to the second story. Pictured below left is the central passage way that doubles as a waiting area for moms and tots. The centre picture shows the flooding after a torrential downpour. The far right shows the same passage way after the 2014 renovations.

2014 Renovations

In early 2014 renovations to mitigate the flooding and complete a second story were finished. This $28K project was a collaboration between Imani Care International (a California based charity) and the Rotary Club of Eganville with support from the Rotary Club of North Renfrew. The rear part of the Clinic that was prone to flooding was raised by about a meter and the interior of the premises was completely refurbished.This included upgraded electrical wiring as well as new plumbing for wash basins and toilets which are now connected to the municipal sewer.

Peter with new oxygen concentrator

August 2016- In-Patient Accreditation Granted!

Peter and Francisca’s goal from the beginning was to attain in-patient accreditation with the Kenyan National Hospital Insurance Fund (NHIF) as this would help the Centre become sustainable. The renovation went a long way to meet NHIF requirements but additional steps had to be undertaken. These included the provision of kitchen equipment, the purchase of 15 additional hospital beds with sheets and mosquito nets and access to oxygen. The Rotary Club of Chesterville, Ontario made funds available to collaborate with the Rotary Club of Eganville to purchase the beds and the oxygen equipment.

On August 8th 2016 Peter and Francisca wrote: We have good news! We are very pleased to officially inform you that God has been gracious to us and that we are at last officially on board with NHIF Inpatient. It has been a long journey of prayers, hard work, and patience for all of us. We sincerely THANK YOU for encouraging and supporting us financially as we made improvements at the Imara healthcare facility, which has eventually contributed to this accreditation.

We are optimistic that many community members will equally benefit by accessing quality, affordable and holistic healthcare service at Imara Healthcare Centre.

The Next Steps – Training Community Health Workers (CHWs)

Peter and Francisca see the evolution of the Imara Healthcare Centre occurring through outreach and education. They want to put more emphasis on the use of Community Health Workers who can act as mediators between the Healthcare Centre and the population in the different communities in the Mukuru slum. They also want to develop programs to educate and empower young people.Benefits of CHWs

Coming from the community in which they work, CHW’s can gain access and develop trusting relationships with community members needing health care

They are in a position to provide early diagnosis and treatment of health issues

They can monitor pre- and post-natal care

Providing home-based care, CHWs are in a position to suggest improvements in hygiene in the home and promote healthy living

They can act as an effective liason between communities in the slum and the Imara Healthcare Centre

There is evidence that CHW’s can be a powerful force in improving health outcomes for populations where health resources are limited

The Community Health Worker Project – 2015-16

On April 16th 2015 Ed Byers, Eganville Rotary Club President and Alan Fox, Club Chair of International Services committee, signed the Rotary International Matching Grant Program application. In May the application was submitted.

The goals of this project are as follows:

· Undertake two weeks of intensive training for 15 people from different communities in the Mukuru slum

· Build team spirit by providing the trainees with uniforms branded with the Imara and Rotary logos

· Supply them with bags with necessary medical supplies for home visits

· Encourage retention in the program by paying the trainees a honorarium of $25/month during their nine month apprenticeship at the Imara Healthcare Centre

The Rotary Clubs of Arnprior, Pembroke and Petawawa and Renfrew have agreed to partner with the Rotary Club of Eganville and contribute funds to this $16,500 project. Also, the Rotary Club of Milimani in Nairobi has joined the partnership and will provide on the ground oversight.

In late October 2015, word was received that the Matching Grant application had been approved. The CHW course was held in Nairobi and 18 graduates received their certificates. The graduation ceremony was attended by Rotarians Mona and Alan Fox from the Eganville Rotary Club. Also attending was Rotary Past President David Rabour of the Homa Bay Rotary Club, Western Kenya. Past President Rabour was an instructor on the course. The graduates were provided with tote bags for their medical supplies when needed for their new duties as well as a uniform shirt and umbrella. An honourarium of about $25/month is being paid to the graduates during their apprenticeship until the end of August 2016.

In early December, Peter reported that most of the Community Health Workers (CHWs) had been involved with a Polio vaccination campaign in the Mukuru slum. Rotary has a long standing interest in the eradication of polio through it's PolioPlus program which was launched in 1985.

The CHWs responded to an outbreak of cholera in Mukuru in January. They took a week to go door to door in the slum to tell residents about the importance of hand washing and hygiene in avoiding contracting the disease. They also went to seven schools in Mukuru and gave the same message to 2,700 students and 175 teachers.

On their visit to Imara, Alan and Mona took with them a Physician's Travel Pack donated by Eganville Rotary. The amount and variety of the medicines supplied were appreciated at Imara. Our club's hope is that the CHW program becomes self sustaining. To that end, the project has built into it, funding for a modest stipend for each worker for a period of 9 months.

2016-2017 Project: Operating Room Equipment

Eganville Rotary’s next project is to help in the acquisition of equipment for Imara’s Operating Room. Eganville Rotary has been awarded a District Matching Grant to purchase an Operating Table; an Anaethesia Machine; a Patient Monitor; and, a Suction Machine. The total cost of the equipment amounts to almost $23,000. Half of the cost will be covered by the District Grant program. It is expected that the equipment will be installed by the end of March 2017.

In addition to the support from the Rotary Club of Eganville, this project is being supported by a partnership of the following Rotary Clubs: Arnprior, Renfrew, Pembroke, Petawawa, Shawville, La Fondation Coup de Coeur (Montreal), Sowerby Bridge (Yorkshire UK) and Syokimau (Nairobi) We gratefully acknowledge their support as well as the generous contributions of many individual donors.

A large part of Imara’s business is the reproductive care of mothers and their infants. In the case of complications in the pregnancy they will now be able to do caesarian sections. The acquisition of this equipment will increase the safety of mother’s having babies in Mukuru and will improve the medical infrastructure of the slum community.

Over the longer term Peter and Francisca want to find ways to bring reproductive healthcare to the poor and marginalized in Mukuru. Maternal and infant mortality rates in the Nairobi slums are unacceptably high and it is the poor and marginalized that are most at risk.

Operating Theatre Update

A large part of Imara’s business is the reproductive care of mothers and their infants. However, at present, if there are complications in a mother’s pregnancy, she has to travel a number of kilometers to either the Kikuyu Hospital or the Mama Lucy Kibaki Hospital. Having a fully equipped community based Operating Room in Mukuru will save lives. In the case of complications in the pregnancy, the Imara Centre will now be able to do caesarian sections. The acquisition of this equipment will increase the safety of mother’s having babies in Mukuru and will improve the medical infrastructure of the slum community.

Peter and Francisca’s aim is to bring reproductive healthcare to the poor and marginalized in Mukuru. Maternal and infant mortality rates in the Nairobi slums are unacceptably high and it is the poor and marginalized that are most at risk. This initiative should help address this situation.

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January 2019 New Equipment ready for purchase!

Our fundraising in 2018 enabled us to purchase three pieces of equipment: a second patient monitor for the post-natal ward, a baby resuscitator and a baby incubator. We received the news over the Christmas holidays that we have been awarded a District Matching Grant for the equipment purchase. When we told Peter and Francisca about the grant, Peter wrote, “What wonderful news. The news sounded like sweet music. This is truly a New Year gift for Imara”. It is also a gift to the Mukuru community who will benefit from the increased security of patient care. Thank you to the Rotary clubs of Arnprior, Renfrew, Petawawa and Montreal as well as CUPE and an anonymous donor.

some 500 baby caps ready for Imara newborns!

April 2019 UpdateAlan and Mona were in Nairobi to visit the Imara Healthcare Centre and to help to kick start the Siloam School Project. While at Imara, Alan and Mona presented the more than 500 knitted caps for newborns created by Mona and a large network of volunteers. They also did, on behalf of Eganville Rotary and the Rotary Club of Syokimau, Nairobi, officially present the neonatal operating roomequipment purchased for the Centre in January.

On April 6th, Alan and Mona along with Syokimau Rotary membersPresident Major Boke, Dorothy, Isabella and Felisitas (our three guestson Canada Day 2018) were at Imara. There, Peter and Franciscashowed off the newly acquired baby incubator and babyresuscitator as well as the surgical instruments and trolley provided bythe Syokimau Club. Peter Inoti, Healthcare Centre Director praisedRotary's partnership with the community health service since 2011. Thesome 500 donated knitted hats were left at Imara for the yet to be bornMukuru babies.

Francisca Muthoni, the Senior Clinician at Imara has reported that asthe only facility in Mukuru, Nairobi with an Operating Theatre, the ImaraCentre receives referrals from other private and public centres. TheCentre reports that 124 infants have been delivered so far this year.The Centre which was struggling to stay afloat in 2011 is now a busy,vibrant health facility meeting the needs of the Mukuru community.Since January this year it has attended to over 4,000 outpatients

Your support for this project is needed! Canadians can receive a charitable receipt by sending a cheque to the Rotary Club of Eganville Charitable Trust at: PO Box 788, Eganville, ON K0J 1T0. Others may contribute through the PayPal link at the bottom of this page.